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Archives of Gynecology and Obstetrics

, Volume 299, Issue 4, pp 953–960 | Cite as

Obstetrical outcomes of embryo reduction and fetal reduction compared to non-reduced twin pregnancies

  • Mi Sun Kim
  • Sukho Kang
  • Eun Duc Na
  • Jisun Im
  • Eunhee Ahn
  • Ji Eun Shin
  • Myoung Jin MoonEmail author
Maternal-Fetal Medicine
  • 138 Downloads

Abstract

Purpose

To prevent perinatal morbidity and mortality of high-order multiple pregnancy (HOMP), multifetal pregnancy reduction (MPR) is offered to some patients. In this study, we investigated whether twin pregnancies derived from MPRs carry a higher adverse obstetrical outcome compared to non-reduced control group of twins.

Methods

We retrospectively analyzed the data from HOMPs on which transvaginal ER (n = 153) at a mean gestational age of 7.6 weeks or transabdominal FR (n = 59) at a mean gestational age of 12.4 weeks was performed between December 2006 and January 2018. The risk of each procedure was evaluated by comparing obstetrical outcome with that of a control population of 157 non-reduced twins conceived by infertility treatment.

Results

The mean gestational ages at delivery were 35.2 weeks in the ER group, 35.7 weeks in the FR group, and 34.1 weeks in the control group (P = NS). Compared with those in the control group, the ER group had higher miscarriage (1.3% vs. 6.5%; P = 0.047; OR 0.21; 95% CI 0.45–0.898) and higher overall fetal loss (3.8% vs. 14.4%; P = 0.003; OR 0.24; 95% CI 0.09–0.60) rates. Differently compared with those in the control group, the FR group had no statistical difference in miscarriage (2.5% vs. 1.7%; P=NS) and overall fetal loss (3.8% vs. 6.8%; P=NS) rates.

Conclusions

Compared with the control group, ER in twins had a higher miscarriage and fetal loss rate, whereas FR in twins was similar to the control group. So, the FR procedure is overall a better and safer approach of MPR in reducing morbidity and mortality in HOMPs.

Keywords

High-order multiple pregnancies Multifetal pregnancy reduction Twin pregnancy Miscarriage rate Preterm delivery 

Notes

Author contributions

MSK: Manuscript writing, SK: Protocol/project development, data management, EDN: Manuscript writing/editing, JI: Data collection, EA: Data analysis, JES: Data collection, MJM: Protocol/project development.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyCHA Bundang Medical CenterSeongnamRepublic of Korea
  2. 2.Fertility Center of CHA Bundang Medical CenterSeongnamRepublic of Korea

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